Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Andreas Vesalius Bruxellensis (1514- 1564)

A Flemish anatomist and surgeon, Andreas Vesalius was born on December 31, 1514 in Brussels, Belgium. He is considered to be the father of the science of Anatomy. Up until his studies and publications human anatomy studies consisted only on the confirmation of the old doctrines of Galen of Pergamon (129AD - 200AD). Anatomy professors would read to the students from Galen's work and a demonstrator would point in a body to the area being described, if a body was used at all. The reasoning was that there was no need to dissect since all that was needed to know was already written in Galen's books. Vesalius, Fallopius, and others started the change by describing what they actually saw in a dissection as opposed to what was supposed to be there. 

Vesalius had a notorious career, both as an anatomist and as a surgeon. His revolutionary book "De Humani Corporis Fabrica: Libri Septem" was published in May 26, 1543. One of the most famous anatomical images is his plate 22 of the book, called sometimes "The Hamlet". You can see this image if you hover over Vesalius' only known portrait which accompanies this article. Sir William Osler said of this book "... it is the greatest book ever printed, from which modern medicine dates" 

After the original 1543 printing, the Fabrica was reprinted in 1555. It was re-reprinted and translated in many languages, although many of these printings were low-quality copies with no respect for copyright or authorship.

The story of the wood blocks with the carved images used for the original printing extends into the 20th century. In 1934 these original wood blocks were used to print 617 copies of the book "Iconaes Anatomica". This book is rare and no more can be printed because, sadly, during a 1943 WWII bombing raid over Munich all the wood blocks were burnt.

One interesting aspect of the book was the landscape panorama in some of his most famous woodcuts which was only "discovered" until 1903.

Vesalius was controversial in life and he still is in death. We know that he died on his way back from a pilgrimage to Jerusalem, but how he died, and exactly where he died is lost in controversy. We do know he was alive when he set foot on the port of Zakynthos in the island of the same name in Greece. He is said to have suddenly collapsed and die at the gates of the city, presumably as a consequence of scurvy. Records show that he was interred in the cemetery of the Church of Santa Maria delle Grazie, but the city and the church were destroyed by an earthquake and Vesalius' grave lost to history. Modern researchers are looking into finding the lost grave and have identified the location of the cemetery. This story has not ended yet.

For a detailed biography of Andreas Vesalius CLICK HERE.

Personal note: To commemorate Andrea Vesalius' 500th birthday in 2014, there were many scientific meetings throughout the world, one of them was the "Vesalius Continuum" anatomical meeting on the island of Zakynthos, Greece on September 4-8, 2014. This is the island where Vesalius died in 1564. I had the opportunity to attend and there are several articles in this website on the presence of Andreas Vesalius on Zakynthos island. During 2015 I also attended a symposium on "Vesalius and the Invention of the Modern Body" at the St. Louis University. At this symposium I had the honor of meeting of Drs. Garrison and Hast, authors of the "New Fabrica". Dr. Miranda

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Celsus and his influence on Medicine and Surgery

Published: Friday, March 25, 2022 07:00 | Hits: 2180

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Aulus Cornelius Celsus and Title Page De Medicina Libri Octo”
Celsus and Title Page De Medicina Libri Octo”
Click on the image for a larger version

Aulus Cornelius Celsus (25 BC - 45 AD) was Roman, probably born in the south of France. A controversial character, many dispute that he was even a physician or that he actually did what is mentioned in his opus magnum “De Medicina Libri Octo.” According to some, he was what today would be considered a compiler and editor of larger books where each chapter is written by a different author. Others present Celsus as a learned scholar of noble origin, a famous physician, either way, he influenced Medicine and Surgery for centuries. Some of his canons and medical terms he coined are in use today. such as omentum, cancer, vertebra, scalpel, etc.

He is the first to describe the four pillars of inflammation: dolor (pain), rubor (redness), calor (fever), and tumor (swelling) , and in passing criticizes Erasistratus on being wrong about inflammation. In his book he states “Notæ vero inflammationis sunt quatuor, rubor, et tumor, cum calore et dolore. Quo magis erravit Erasistratus, qui febre nullam sine hac esse dixir.” Translates as: “Note that there are four signs of inflammation: redness and swelling, with heat and pain. So much was Erasistratus mistaken, when he declared there was no fever without it.” Celsus popularized the use of the term “cancer”. although it was first used by Galen of Pergamon.

Not much is known about his life or work. Quintilian mentions a work of Celsus on rhetoric, but that work is lost. Quintilian, who apparently was not a fan of Celsus, writes: “…when even Cornelius Celsus, a man of a moderate share of genius, has not only composed treatises on all these arts, but has also left precepts of the military art, agriculture, and medicine.” His quote is what leads Alexander of Padua to state that his book “De Medicina, Libri Octo” is but a small part of a larger treatise that was called “The Arts.” Celsus is known by his book “De Medicina, Libri Octo,” (On Medicine, eight books). This book is sometimes presented as “De Re Medicina, Libri Octo.” Apparently, this book was part of a larger work by Celsus that has disappeared from History. This medical book was handwritten and was lost to history until one copy was discovered in the Vatican Library and released for copying as manuscripts. Of interest is the fact that the book found was titled "Aulii Cornelii Celsi liber sextus. idemque medicinæ primus," making it understood that these were six books, not eight! This was one of the first medical books to be printed upon the invention of the printing press by Gutenberg.

The first book begins with the principles for the preservation of health; the second is dedicated to the symptoms of diseases; the third is describes treatment of diseases which affect the whole organism and the fourth is focused on the diseases where the cause is found only in certain parts of the body, such as in head, lungs etc. The fifth book is dedicated to pharmacology. The sixth, seventh, and the eighth book deal with surgery, wounds, and fractures.

His book describes the importance of cleanliness of a wound and the use of topical treatment that today would be considered antiseptics. His contributions to surgery are many including anatomy of the eye, the description of ophthalmic diseases, methods of preventive treatment and surgery including eyelid surgery. He is probably the first to describe cataract surgery.

The eighth book, almost entirely dedicated to dislocations and fractures, provides an extensive description of head injuries such as extradural hematomas, lesions distant from the impact point, and intracranial damage in cases with no overlying fractures. He also provided the first description of brain swelling exceeding the level of the skull, described several surgical indications and craniotomy techniques, recommended treatment for depressed fractures (which had been previously considered untreatable), and detailed the surgical instruments employed.

De Medicina was among the first medical books to be printed (Florence, 1478), and more than 50 editions have appeared; it was required reading in most medical schools to the present century. It is the principal historical authority for the doctrinal medical teachings of Roman antiquity. The surgical section, which even Joseph Lister studied in the 19th century, is perhaps the best part of the treatise.

W. G. Spencer, the most recent translator of his works, supports an older, minority view that the details of medical procedure, the experienced judgment shown in the selection of treatment, and the frequent use of the first person reveal an author with an intimate acquaintance of clinical medicine who must have been himself a practitioner of the medical arts.

Because of this book and the clarity of the disease descriptions and treatments both pharmacological and surgical. Celsus has been lauded as one of the Fathers of Medicine and Surgery. His influence has stood the test of time and was read well into the 1800’s.

Personal note: This article was motivated by the recent acquisition of a 1713 copy of De Medicina, that is now part of my library. The book belonged to Dr. Harry Kaufmann Hines, a renown radiologist who lived and worked in Cincinnati, OH. The book was a gift to him from his sister-in-law Erma Wright Tateman neé Sharkey in August 1961. Dr. Miranda

Sources:
1. “The Contribution of Aulus Cornelius Celsus (25 B.C.–50 A.D.) to Eyelid Surgery” Davide Lazzeri, Tommaso Agostini, Michele Figus, Marco Nardi, Giuseppe Spinelli, Marcello Pantaloni & Stefano Lazzeri (2012), Orbit, 31:3, 162-167
2. “Aulus Cornelius Celsus and the Head Injuries” GiuseppeTalamonti Giuseppe D'Aliberti, MarcoCenzato World Neurosurgery Volume 133, January 2020, Pages 127-134
3. “A. Cornelius Celsus of medicine. In eight books.” Translated, with notes critical and explanatory, by James Greive, M.D. 1756

For anyone interested in reading an online copy of this book, you can find it here.  For the translation by Greive click here.